Diencephalic syndrome is a rare cause of failure to thrive in infancy and early childhood. The syndrome is characterized by profound emaciation with normal appetite, loss of cutaneous adipose tissue, hyperactivity, euphoria, and nystagmus. It commonly occurs in association with chiasmatic and hypothalamic gliomas. It has also been described in association with other histologic types. There is the marked increase of serum growth hormone, which may exhibit an inappropriate, even paradoxical response in stimulation test. A male infant of 12 months of age, showed markedly elevated growth hormone but he had failure to thrive findings. Evenly enhanced round mass was seen at suprasella area in brain CT. Its histological findings was "Desmoplastic infantile ganglioglioma", very rare histologic type. Here we report a case of diencephalic syndrome presented by failure to thrive in association with hypothalamic tumors.
Adipose Tissue ; Appetite ; Brain ; Emaciation ; Euphoria ; Failure to Thrive ; Glioma ; Growth Hormone ; Humans ; Hypothalamic Neoplasms ; Infant ; Male

PURPOSE: In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. METHODS: Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0b was performed to establish a model for UE. RESULTS: Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. CONCLUSION: Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.
Adult ; Airway Extubation/*psychology ; Female ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Middle Aged ; *Models, Theoretical ; Nonlinear Dynamics ; Risk Factors

No abstract available.
Animals ; Brain* ; Mice* ; RNA, Messenger*

PURPOSE: Tonsillectomy is a very common surgical procedure, particularly in children. The purpose of this study was to identify current evidence in nursing research on pediatric tonsillectomy by analyzing and evaluating Korean nursing studies related to pediatric tonsillectomy. METHODS: An integrative literature review of Korean pediatric tonsillectomy research was conducted. Databases were searched to identify research that related to nursing care for pediatric tonsillectomy children. RESULTS: Of the 115 studies identified, 13 studies met the inclusion criteria for this review. All studies were experimental studies and most of those studies had a quasi experimental design. No correlational studies or qualitative studies were found. Providing nursing information and education for children and their mothers at pre, during, and post tonsillectomy by pediatric nurses were found to be effective in reducing children's pain and anxiety and their mother's anxiety and uncertainty, and increasing children's appropriate sick role behaviors and their mother's satisfaction with nursing services provided and knowledge related to tonsillectomy. CONCLUSION: Although most studies reported positive effects in terms of post tonsillectomy outcomes, lack of methodological rigor limits the current evidences for pediatric tonsillectomy nursing interventions. Greater attention to improve methodological rigor for Korean research on pediatric tonsillectomy is needed.
Anxiety ; Child ; Education ; Humans ; Mothers ; Nursing Care ; Nursing Research ; Nursing Services ; Nursing* ; Parents ; Pediatric Nursing ; Research Design ; Sick Role ; Tonsillectomy* ; Uncertainty

PURPOSE: The purpose of this study was to investigate the use of schoolbags and the prevalence of musculoskeletal symptoms among elementary school children and to identify factors associated with relative schoolbag weight and musculoskeletal symptoms. METHODS: A descriptive correlation study was conducted with 228 elementary school children in grades 4-6. A self-administered questionnaire was used for data collection. Descriptive statistics, t-test, ANOVA, chi2-test or Fisher's exact test, logistic regression analysis were used for data analysis. RESULTS: Mean relative schoolbag weight (RSW) was 6.40%. Among participants, 13.2% carried more than 10% of their RSW. Only 49.6% of participants organized the contents in their school backpack correctly. Musculoskeletal symptoms were reported by 42.5% of participants. Results from logistic regression analysis identified grade was a significant factor predicting RSW, and gender, RSW, and using a locker were significant factors predicting musculoskeletal symptoms among schoolchildren. CONCLUSION: Although RSW of school children in this study was within the currently recommended load limit, a considerable proportion of school children were not following guidelines for safe schoolbag use. An effective schoolbag safety campaign for parents, students, and teachers needs to be developed and evaluated to prevent possible musculoskeletal symptoms related to schoolbag use.
Child* ; Data Collection ; Humans ; Logistic Models ; Musculoskeletal Pain ; Parents ; Prevalence ; Statistics as Topic

No abstract available.
Castration ; Granuloma ; Granuloma, Foreign-Body

PURPOSE: The purpose of this study was to develop a system dynamics model for adolescent obesity in Korea that could be used for obesity policy analysis. METHODS: On the basis of the casual loop diagram, a model was developed by converting to stock and flow diagram. The Vensim DSS 5.0 program was used in the model development. We simulated method of moments to the calibration of this model with data from The Korea Youth Risk Behavior Web-based Survey 2005 to 2013. We ran the scenario simulation. RESULTS: This model can be used to understand the current adolescent obesity rate, predict the future obesity rate, and be utilized as a tool for controlling the risk factors. The results of the model simulation match well with the data. It was identified that a proper model, able to predict obesity probability, was established. CONCLUSION: These results of stock and flow diagram modeling in adolescent obesity can be helpful in development of obesity by policy planners and other stakeholders to better anticipate the multiple effects of interventions in both the short and the long term. In the future we suggest the development of an expanded model based on this adolescent obesity model.
Adolescent ; Humans ; Internet ; *Nonlinear Dynamics ; Obesity/*pathology ; Republic of Korea ; Risk Factors ; *Risk-Taking ; Surveys and Questionnaires

Human carboxylesterase 1 (CES1) is a serine esterase that hydrolyzes various exogenous compounds. Single nucleotide polymorphisms (SNPs) of CES1 may lead to inter-individual metabolic variability of its substrates. The allele and haplotype frequencies of known SNPs have been demonstrated to vary among ethnic groups. We analyzed genetic variations of CES1 in a Korean population. Direct sequencing of all exons and flanking regions of the CES1 gene was performed on samples obtained from 200 Koreans. We identified 41 SNPs. The most frequent SNPs was -914G>C (frequency: 99.5%), followed by 4256G>A (frequency: 65.8%), -75T>G (frequency: 59.3%). Haplotype analysis using the identified SNPs revealed fifteen haplotypes (> or =1% haplotype frequency) in our samples. The most frequent haplotype was Hap1 (frequency: 15.4%). Among the identified 41 SNPs, nine of which are novel variants and 14 SNPs were nonsynonymous variants. Using the functional predictive software PolyPhen-2, the G19V, E221G, and A270S variants were predicted to be most likely damaging to the function and structure of CES1. In-vitro analyses for two of these variants have been previously performed; however, functional evaluation of E221G (11657A>G, rs200707504) still needs to be conducted. Therefore, further studies are warranted to characterize the functional impact of E221G on CES1 activity.
Alleles ; Asian Continental Ancestry Group ; Carboxylesterase* ; Ethnic Groups ; Exons ; Genetic Variation ; Haplotypes ; Humans ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Serine

PURPOSE: Fever in newborn might be an indicator of serious bacterial infection. Differentiating environmental from disease-related temperature elevations in newborn is clinically important, because neonate with environment-related temperature elevation might be subjected to an unnecessary work-up to detect occult disease. But there are exists no consistent conclusions about environmental effect in previous literatures. We prospectively evaluated the effect of bundling on body temperature. METHODS: Twenty-five well, full-term newborns within 1 week old were assigned to the control group (one blanket) or to the study group (five blankets and hat). Rectal and axillary temperatures and arousal states were measured at 15-minute interval for 2 hours. RESULTS: There were 13 control and 12 study newborns. The mean axillary temperature of contol group increased by 0.21 degrees C; mean rectal temperature increased by 0.23 degrees C. The mean axillary temperature of study group increased by 0.63degrees C; mean rectal temperature increased by 0.56 degrees C. Comparing study newborns to controls, there were significant rises in both axillary temperature and rectal temperature. One newborn of the study group reached 38.3 degrees C in rectal temperature. CONCLUSION: Bundling can cause significant elevations in axillary and rectal temperature in newborn within 1 week old. Therefore, physicians treating neonates with elevated temperature should question whether to use bundling to differentiate endogenous from exogenous causes.
Arousal ; Bacterial Infections ; Body Temperature* ; Fever ; Humans ; Infant, Newborn ; Prospective Studies

PURPOSE: To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) treatment of eyes with foveal serous retinal detachment (SRD) associated with inferior staphyloma and to investigate choroidal thickness changes following anti-VEGF therapy. METHODS: In this observational case series, eyes with inferior staphyloma accompanied by foveal SRD were treated with a single intravitreal anti-VEGF injection, followed by further injections as needed. Changes in height and width of subretinal fluid (SRF) and visual acuity after treatment were assessed. Choroidal thickness was measured at the subfovea, 1.5 mm superior and inferior to the fovea using enhanced depth imaging optical coherence tomography at baseline and 1 month after initial anti-VEGF therapy. RESULTS: Six eyes from six patients were included. One month after the initial injection, the mean SRF height and width had decreased significantly from 112.5 ± 40.1 to 44.5 ± 48.7 µm (p = 0.046) and from 1,401.8 ± 627.3 to 690.7 ± 634.7 µm (p = 0.028), respectively. Mean choroidal thickness at the superior point decreased from 218.7 ± 59.3 to 200.5 ± 61.0 µm (p = 0.046). SRF resolved completely in three of the six eyes (50%) with a mean of 6.8 ± 5.9 injections (range, 1 to 15). All eyes experienced at least one recurrence of exudation, at a mean interval of 4.8 months. Mean visual acuity improvement was 0.17 logarithm of the minimum angle of resolution units at a mean of 28.7 months follow-up. CONCLUSIONS: Anti-VEGF therapy resulted in an SRF decrease and modest visual improvement in eyes with foveal SRD associated with inferior staphyloma. Reduction in superior choroidal thickness appeared to contribute to the clinical improvements that were observed.
Choroid ; Endothelial Growth Factors ; Follow-Up Studies ; Humans ; Recurrence ; Retinal Detachment ; Retinaldehyde ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity